The mission of the Yale Older Americans Independence Center (OAIC), established in 1992, is to provide intellectual leadership and innovation for aging research that is directed at enhancing the independence of older persons. The unifying theme of the Yale OAIC remains the investigation of multifactorial geriatric health conditions, encompassing single conditions resulting from multiple contributing factors or affecting multiple outcome domains and multiple conditions occurring simultaneously. The Yale OAIC hypothesis is that geriatric health conditions are determined by the co-occurrence of multiple predisposing and precipitating factors. These conditions and factors, in turn, affect a range of health outcomes. The predisposing factors may be at the genetic, molecular, physiologic, impairment, disease, or socio-demographic level, while the precipitating factors may be behavioral, environmental, social, medical, or psychological. As a related subtheme, the Yale OAIC also aims to advance the science of clinical decision making in the face of tradeoffs and multiple competing outcomes. This includes developing strategies to elicit older persons' health outcome priorities. The Specific Aims of the Yale OAIC are to: 1) foster the career development of future academic leaders, from multiple disciplines, in aging research; 2) train investigators, biostatisticians and other methodologists in the skills necessary to design, conduct, analyze, and disseminate findings from studies of multifactorial geriatric health conditions; 3) develop and disseminate design and analytic techniques for conducting studies of multifactorial geriatric health conditions; 4) develop strategies for recruiting into, and retainin, a broad spectrum of older persons, including minorities, into studies of multifactorial geriatric health conditions; 5) investigate the causative mechanisms of, and develop and test effective treatments for, geriatric health conditions from a multifactorial research perspective; 6) develop strategies to enhance clinical decision making in the setting of multiple health conditions; 7) encourage and facilitate interdisciplinary research (basic, translational and clinical) that connects to our focus on multifactorial geriatric health conditions; and 8) develop and implement strategies that will facilitate the translation of OAIC research into practice and policy. The Yale OAIC cores include: 1) Leadership and Administrative; 2) Research Career Development; 3) Pilot/Exploratory Studies; 4) Operations; 5) Biostatistics; and 6) Information Dissemination. For the first 1 to 2 years of the next cycle, we propose to support 4 RCDC candidates, 3 pilot studies, 2 development projects, and 17 externally funded projects.